Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 28, 2023
Date Accepted: Oct 21, 2024
Please, fix me: Guided internet intervention participants may not benefit if they hardly engage but seek much contact with therapists
ABSTRACT
Background:
Guided internet interventions are efficacious in reducing depressive symptoms. High-adherent participants seem to respond better to therapy than low-adherent participants. Easily measurable aspects of guidance, such as the number of messages sent by participants, might also inform about treatment response.
Objective:
In this short paper, we explored whether participants respond differently to treatment depending on their adherence level and how much contact participants sought with the therapist providing guidance.
Methods:
We used participant data from a randomized full factorial trial for the present analyses. We divided the completer sample (n = 113) into four groups based on median splits of two variables (adherence and participants' messages). Then, we compared the four groups regarding the change in depressive symptoms.
Results:
Overall, high-adherent participants responded better to therapy than low-adherent participants. Low-adherent participants who wrote many messages did not respond to therapy. The non-response was shown by the changes in Patient-Health Questionnaire-9 from pre- to post-treatment (M = 1.6, SD = 4.2) and pre-treatment to follow-up (M = -0.5, SD = 2.3). Interestingly, these participants were more often in concurrent psychotherapy than the other participants.
Conclusions:
Low-adherent participants writing many messages may not benefit from guided internet interventions. Clinical Trial: ClinicalTrials.gov (NCT04318236)
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